​4 Patterns, 8 Steps: A Theory of Internal Medicine

​By Ken Andes, L.Ac.

An attempt to simplify complicated cases

Since the start of my professional practice in 2003, most of my patient cases are what I call “medical throw-aways”. These are patients who have not found results either with conventional western medicine or what I call “health food store” alternative medicine. The average patient at my clinic has seen about 7-8 different doctors/specialists before coming to me out of desperation.

I’m actually ok with this, and the reason why is because both conventional medicine and “health food store” alternative medicine tend to work very well for the vast majority of cases. I’d say that for at least 80% of early health issues, a trip to your general physician, cleaning up your diet, or looking in a basic home remedy book will do the job.

I see the outliers. The cases I see tend to be complex with multiple symptoms in multiple areas of the body. Chronic pain is often accompanied by digestive issues. Hormonal problems tend to come with sleep and blood sugar issues. Anxiety disorders tend to come with upper gastric problems and issues related disorientation and the vestibular system.

The most pressing cases are the ones that involve what I call “umbrella” diagnoses. An “umbrella” diagnosis is one that is used to cover a large variety of health issues and is often used when a general practitioner cannot find a definite reason for the patient’s suffering. Current umbrella diagnoses include:

Lyme, including numerous co-infections such as babesia, bartonella, morgellon’s, etc.

MTHFR mutation

Heavy metal and chemical toxicity (including mercury toxicity)

Epstein-Barr

Fibromyalgia/Chronic Fatigue

Kryptopyrroluria (KPU)

And many others….

I don’t mean to discount or downplay the above diagnoses. I work with many physicians who diagnose and treat the above issues and get great results with patients. But a large percentage of my practice are people who have been trying to treat an umbrella diagnosis for a long time (and spending a small fortune) and are still sick.The dilemma that I’ve struggled with is how to take these complex, non-responding cases and work with them in a way that is focused, gentle, effective in use of time and energy, and yes…cost efficient so that care is available to all who need it.

This paper reflects my current thoughts (2018) on how to classify illness in terms of systemic patterns. It is based on 15 years of treating an estimated 23,000 patient cases….including both miraculous results and embarrassing failures.

Disease names change, but the way the body suffers doesn’t

A central tenant of Traditional Chinese Medicine (TCM) is that disease names change and evolve through history, but the way the human body breaks down is exactly the same now as it was 2,000 years ago.

Take stomach pain as an example. In ancient days it could be seen as pathological humours in the belly (ancient Greek medicine), cold stagnation (Chinese), pitta imbalance (Ayurveda), etc. Today it can be called a multitude of names starting with simple terms like gastric reflux disease and then progressing to more specialized terms such as leaky gut or hypochlorhydria.

But at the end of the day, whatever you want to call it, it’s just stomach pain. Stomach pain has been around for as long as there’s been people, but what we call it and how we view the cause of it changes every few years. I would bet that how we view it 100 years from now will be very different from how we see it today.

The stomach pain that your ancestor felt a thousand years ago is the same stomach pain that you feel today whether you want to call it “cold stagnation” or “leaky gut” or “H. pylori”. TCM has ways to relieve stomach pain that work just as well today as they did a thousand years ago. The trick is to find the right remedy for the right patient and not follow a cookbook formula. The people I see have already tried the cookbook formula and it didn’t work.

This is how Chinese medicine fits within the modern landscape. A patient with stomach pain will come to me and say that they have leaky gut or Lyme or parasites, etc. I’m not as interested in the modern interpretation of the stomach pain because that’s all it is…an interpretation. The illness name is a “theory” as to why the pain is there but it does not describe what the patient is feeling. This distinction is critical.

In Chinese medicine we see and treat the stomach pain within the context of what is happening to the rest of the patient’s body, even if the patient’s other symptoms do not seem related to their stomach.

And of course, I am only using stomach pain as an example. The same line of thought applies to all symptoms of ill health including fatigue, insomnia, pain, allergies, anxiety, etc.

Concept of disease patterns in Chinese Medicine

The body is interconnected as one unit. Because it is connected as one unit it gets sick as one unit. Your symptoms never happen in isolation but must be seen within the context of what the rest of your body is doing.

As an example, let’s say Mr. Smith has fatigue. It’s not good enough to know he has fatigue and then prescribe an energy booster like ginseng. What if Mr. Smith also has insomnia and can’t sleep? Giving him the ginseng will make his insomnia worse. And if he can’t sleep it probably makes sense that he’s tired because he’s not sleeping. Maybe his sleep should be fixed first to see if that corrects the fatigue.

But what if Mr. Smith can’t sleep because he gets migraines at night? The migraines keep him from sleeping which then causes him to be tired during the day. Shouldn’t you really be treating the migraines then and not just the insomnia?

The wrong thing to do would be to try to treat each symptom separately with different remedies. This is how people end up taking a shopping bag full of 20 different supplements, each trying to do something different, but doing nothing but giving them a bloated stomach and empty wallet.

The point I’m trying to make is that you can’t treat the patient’s health complaints in an isolated fashion. The entire context of how their body behaves must be taken into consideration and the true cause must be discerned…even if the true cause seems to have nothing to do with the patient’s main complaint.

This is how good Chinese medicine is practiced. Over thousands of years the Chinese have noticed that the body tends to get sick in very predictable behavior patterns that encompass a wide range of symptoms. They have noticed things like how digestive issues lead to cognitive impairment, urinary problems lead to irritable bowel, and breathing problems often correlate to skin disorders.

Over thousands of years these correlations have been documented into illness patterns with archaic names such as “liver qi stagnation” or “kidney yin deficiency”. The idea is that if you discover the behavior pattern of the disease and treat it directly, all of the patient’s problems will begin to resolve with minimal intervention.

TCM in modern America: Purist vs. Modernist

At the extremes there are two types of Chinese medicine practitioners, the purist vs. the modernist.

The purist believes that all medical thought peaked in the Han Dynasty (China circa 200 B.C.) and that anything that deviates from the ancient literature is not “real” Chinese medicine. The purist ignores the value of modern understanding of anatomy and physiology.

The modernist believes that Chinese medicine was founded upon superstitious beliefs that need to be thrown out and updated with evidence-based practices. Techniques and concepts must be “approved” by peer-reviewed journals before being used to treat patients regardless of historical use.

These are two extremes. The vast majority of Chinese medicine practitioners will fall somewhere in the middle of those two extremes. This is where I consider myself to be. I believe the ancient Chinese were empiricists. They did the best they could to solve the puzzle of medicine using the knowledge they had. And I think they did an amazing job.

However, I also think that Chinese medicine can be improved by incorporating modern understanding of anatomy and physiology, at least within the context of seeing illness as a systemic pattern that involves multiple body systems.

4 Tissue Patterns

The concept of disease states as 4 tissue patterns is my personal attempt at practicing this ancient medicine within the context of modern physiological principles. This is my own unique theory that I gradually developed over years of treating thousands of chronically ill patients.

It was after about 10 years of clinic work that I started noticing 4 distinct illness patterns with my patients, and I have been refining this thought process since 2012. Because it’s my own theory, I don’t have any academic references for it although I will do my best to explain it in detail.

The concept of disease patterns can be seen in several ancient systems of medicine. The Chinese classified disease in terms of 5 elements: metal, water, wood, fire, earth. The ancient Greeks classified in terms of four humours: blood, yellow bile, black bile, phlegm. The ancient Hindus classified in terms of the three doshas of Ayurveda: vata, pitta, kapha. Our ancestors, regardless of where from, placed great importance on first being able to see the entire patient’s state of existence in a clear fashion. They were aware that focusing on isolated symptoms tends to produce isolated results.

The important thing is not which system of classification is correct. They are all correct if used in the proper context. What’s important is the use of a thought model that takes the multitude of complex symptoms and gives those symptoms a sense of cohesion that can then be treated in a way that addresses the entire body as a single unit.

The most basic level of the body is chemical. Elements such as carbon, oxygen, phosphorus, calcium, amino acids, fatty acids etc. comprise the basic building blocks of the body.

These chemical elements combine to form cells, the second level of the body.

The third level is that of tissue. The cells combine to form tissue and there are only 4 different types of tissue in the body. The four types of tissue are: nerve, connective, epithelial, and muscular tissue. All of the different organs and body parts are composed of these four, and only these four tissues.

The fourth level is that of organs. The four tissue types combine in various ways to form the organs such as heart, brain, liver, thyroid, etc. Each organ will have elements of different tissue types, although there will be a dominant tissue trait with each organ.

The fifth level is that of systems. Different organs and tissues work together to form body systems such as the cardiovascular system, digestive system, urogenital system etc.

It is said that illness will begin at the cellular level (first level), but it will be expressed through the systems level (fifth level).

This means that something basic to all cells such as the ability to process oxygen can have wide ranging effects on the body systems depending on which cells are dysfunctional and what tissues they belong to.

If the affected cells belong to connective tissue they can affect bones, tendons, ligaments, adipose tissue, and blood. You will often see these various tissues become ill all at once since they originate from the same tissue type…connective tissue.

If the affected cells belong to epithelial tissue they can affect the endocrine glands (and thus hormones), kidneys, adrenals, sympathetic nervous system, and of course the skin.

If the affected cells belong to nerve tissue they can affect the brain, heart, autonomic nervous system, and gut primarily.

If the affected cells belong to muscular tissue they can affect the lymphatic system, mitochondria (and thus energy production), immune system, and of course muscles.

At what level do you assess and treat?

Among the five levels of anatomical organization discussed above, what level do you assess and treat to get the best results? How do you both make the patients’ symptoms better while at the same time restoring their health?

If you’re still reading this I’m assuming you are a more educated patient and thus realize that making a person feel better does not necessarily equate to restoring health. You can just take drugs or even mega-dose herbs/vitamins (which then have pharmacological effects at these high doses) to suppress the symptoms but that doesn’t make you healthy.

Treating at the upper level of body systems lends to symptom based treatment. This is where you go to the health food store with a stomach ache and take a bottle of herbs that says “stomach remedy” on it. And this works a large percentage of the time…but not for the people that I end up seeing.

Treating at the chemical and cell level is actually a great idea. This involves broad therapeutic approaches such as cleaning up your diet, improving circulation through exercise, getting fresh air, and avoiding toxic exposures.Yet treating at the chemical and cell level may not be specific enough to give relief to advanced health issues. Even though it’s still necessary for other therapeutic approaches to work.

In my practice I have found that a “sweet spot” in the levels of body organization exists at the level of the four tissue types. It’s just above the cellular level making it a bit more specific, but below the organ level making it more systemic for the whole body. Remember, every part of your body is going to fall into one of the four tissue types: nerve, connective, epithelial, muscle. There is nothing outside of these 4 tissue types.

The 4 tissue types as the connection between confusing symptoms

Each of the four basic tissue types (nerve, connective, epithelial, muscle) become differentiated into different organs and body parts yet maintain similar behavior traits. It is through an understanding of the tissue types that you can see how different body parts are connected to each other through a shared tissue type.

With this understanding, you avoid “symptom chasing” by trying to treat every problem that the patient has with a different pill/supplement/herb/pressure point, etc. This is how people end up on a shopping bag full of supplements and spending a fortune on different treatments for different problems. A more efficient approach would be to find the common theme among the tissue types and treat that. By focusing on the tissue type the treatment has a broad scope that is still focused on the patient’s immediate concerns.

In chronic illness, the body deteriorates in a system wide manner and not in an isolated fashion. Symptoms that may not seem to be related to each other such as psoriasis, anxiety, palpitations, constipation, and glucose intolerance are indeed related to each other through a shared tissue type. Being able to identify the primary tissue disturbance is (in my opinion) the most important aspect of getting the patient’s entire body back to health in the most efficient manner.

The 4 tissue patterns: key organs/tissues and associated symptoms

What follows is a very brief description of how we view the four tissue patterns at my clinic. We do this by observing key organs/tissues and their associated symptoms.

I am writing this with the educated layperson in mind. I’m not writing this for other health care professionals or academics. Perhaps in the future I’ll write a more nerd-friendly version but for now this is for the regular person who’s interested in my personal approach towards Chinese medicine.

Nerve tissue pattern

Key elements: heart, brain, digestive tract

Key symptom: Autonomic dysregulation

In the nerve tissue pattern we see problems related to the heart, brain, and digestive tract. These three body parts are connected in that they contain the largest concentrations of nerve activity in the body.

In a nerve tissue pattern, any combination of heart, brain, and digestive tract issues can manifest. It can involve one organ or all three. The key trait of the nerve tissue pattern is a breakdown in the function of nerve tissue related to its three main body areas.

This breakdown of nerve activity can happen in many ways, but the primary trait that we see is autonomic dysregulation between the sympathetic and parasympathetic branches of the nervous system.

We talk about this elsewhere on the website, but in my opinion the sympathetic and parasympathetic branches of the autonomic nervous system represent what the ancient Chinese described as Yin and Yang.

Yang is active, aggressive, and fast. This is analogous to the sympathetic branch of the nervous system (SNS) that represents the “fight or flight” reflex. It is in the SNS state that the body releases stress hormones such as epinephrine to combat real or perceived threats.

Yin is resting, passive, and slow. This is analogous to the parasympathetic branch of the nervous system (PNS) that represents the “rest and digest” reflex. It is in the PNS state that the body goes into rest and healing.

This balance between PNS and SNS, Yin and Yang, is constantly at work in your body as you go through the day. When action and response to threats are needed, the SNS becomes activated. During times of rest when healing is needed, the PNS becomes activated.

PNS and SNS control all involuntary body functions such as heartbeat, digestion, and hormonal activity. Another way to think about this is that the PNS is the brake pedal on the car while the SNS is the gas pedal. One is for stop and rest, the other is for get up and go.

Autonomic dystonia

When PNS and SNS do not function properly you can end up in a state of neurological disorganization called “autonomic dystonia”.

In autonomic dystonia, the body is not able to properly regulate PNS and SNS functions. The autonomic dystonia patient feels as if they have lost control over their body and that they do not respond predictably to stimuli.

To use the car analogy, in autonomic dystonia it is as if someone has switched the locations of the gas pedal and brake without telling the driver. The person tries to stop the car but ends up hitting the gas pedal and vice versa. They feel that they do not have control over the vehicle.

The autonomic dystonia patient has paradoxical responses to stimuli. For example this is a person who drinks a cup of coffee and gets sleepy from it. They can drink a sedative such as chamomile but then end up feeling jittery with heart palpitations.

In a state of illness the autonomic dystonia patient does not respond predictably to care. Treatments that work well for most people tend to have the exact opposite effect and actually make them feel worse. They take a laxative and it ends up constipating them. They take an anti-inflammatory pill and it puts them in severe pain.

What’s happening in this case is that the body has lost the ability to appropriately respond to stimuli. This is a dysfunction in the ability for the body to upregulate (SNS) and downregulate (PNS) in a consistent manner.

The key to treating this type of patient is not to give them more cookbook recommendations based on their symptoms. The key is to first identify that they are not able to properly respond to healing stimuli, then work to correct the disorganization in the autonomic nervous system. That needs to be the first thing done and in my experience it is often the only thing that is needed for this type of patient to feel better.

Heart and Gut as neurological organs

I mentioned that the key players in a nerve tissue pattern are the brain, heart, and digestive tract (gut). Everyone can understand that the brain is a neurological organ but referencing the heart and gut as neurological organs will take some explaining.

Neurocardiology

Up until the 1980’s the heart was seen as nothing more than a pump for the blood. But since the 1980’s a new medical specialty called neurocardiology has emerged as scientists have discovered that the heart contains an elaborate nervous system that rivals that of the brain. Before neurocardiology it was believed that the brain controlled the heart. Many scientists now believe that it is the other way around.

The heart has its own autonomous nervous system that functions independently from the brain. The heart is the first organ to form after conception. In the unborn fetus the heart starts beating before the brain is even formed and the initiation of the heartbeat comes from within the heart itself and not from the brain.

The heartbeat is not dependent upon control from the brain. During heart transplants the nerves that connect the heart to the brain are severed and yet the heart still continues to beat on its own. The heart can then be implanted into another persons’ chest and will continue to beat even without re-establishing a neurological connection to that persons’ brain.

The science of neurocardiology has shown that it is actually the heart that controls the brain, not the other way around. The heartbeat functions as a delivery mechanism of neural impulses that travel up to the brain via the vagus nerve. These impulses carry information about what is happening in the body from a hormonal and neurological standpoint and give further instructions to the brain on how to regulate the body.

The brain takes orders from the heart, not the other way around.

Heart as an energetic/electrical center

The science of neurocardiolgy has proven what ancient systems of medicine such as TCM have known for thousands of years: the heart is the primary regulator of the body’s energetic and electrical functions.

The heartbeat is a vehicle through which electrical impulses are conducted throughout the body. These electrical impulses also carry information and instructions to all of your cells. The electromagnetic field produced by the heart is the most powerful in the entire body; it’s approximately 5,000 times stronger than the electromagnetic field produced by the brain.

Because of the strength of the heart’s electromagnetic field it not only reaches every cell in your body but extends at least 8 feet outside of us as measured by modern detection devices (magnetometers).

The heart is the most electrical organ in the body and the governor of neurological communication, not the brain.

Blood pressure as a form of body communication

People think that when they feel their pulse that they are feeling the movement of blood underneath their skin. That’s not true.

With every heartbeat, the heart generates a blood pressure wave that travels throughout the arteries much faster than the actual flow of blood. It’s this pressure wave that you are feeling when you take your pulse, not the actual blood.

The science of heart rate variability (HRV) has shown that this pressure wave is also a form of communication between the heart and the rest of the body. The variation in pressure waves carries information that determines how the rest of the body behaves.

Pressure is a form of energy. A gentle touch on the skin conveys a certain energy, whereas a hard slap on the face conveys a different energy. The pressure waves generated by the heart do more than just push blood through the arteries; they compromise an ongoing dialogue between the heart and every organ, gland, and cell in your body. The blood pressure waves represent the internal dialogue between your heart and the rest of your body.

Pressure waves and gastrointestinal function

This is my own theory and I haven’t seen it written about anywhere else. If someone reading this has seen it published elsewhere I’d appreciate it if you let me know about it.

In my clinic I have observed that the blood pressure waves of the heart have a regulatory effect on the peristalsis of the intestines. This has led me to conclude that many stubborn GI problems are actually due to issues with the heart rhythm (and thus the autonomic nervous system).

I owe this observation to the autistic children I’ve had the privilege of treating. Many of them have severe constipation issues that do not respond to either conventional or alternative care.

The child’s parents would talk about how the kid would only have a bowel movement every few days (although bowel movements every 7 days was not uncommon) and many of the more educated ones were already aware of how most of our neurotransmitters were made in the gut; and that constipation impaired cognitive development of the child.

By the time I saw their child they had tried everything commonly used for constipation including: probiotics, prune juice, aloe vera, magnesium, herbal laxatives (i.e.: senna), etc. and nothing had worked. Because I didn’t know what else to do I tried using the same things that they had already tried but from different companies and perhaps with some Chinese herbs.

And of course, none of it worked and I ended up looking like a fool.

When I began researching the heart and how the pressure waves were another form of body communication I reasoned that maybe the pressure waves in the gut functioned based on the rhythm of the pressure waves from the heart. I noticed that the pressure waves that moved through the arteries looked similar to the pressure waves that the gut uses to create peristalsis.

Gut function is based on peristalsis. Peristalsis is the wave-like contraction of the smooth muscles of the gut as they move food through the colon. This movement in the colon is key to digestion, absorption, and the proper elimination of feces.

If the heart was the true neurological “king” of the body from which all other organs took orders, then perhaps the lack of peristalsis in the gut was due to improper signaling from the heart. This improper signaling would then be due to improper pressure waves because of an imbalance in the autonomic nervous system (balance of PNS and SNS, Yin and Yang).

I then began shifting my focus from directly treating constipation, to treating the autonomic balance of the heart using the tools I had at the time.

The results were outstanding. Better than anything I had used in the past. I was able to get many of these children to have more frequent and healthy bowel movements and this translated to better cognitive function (more on that soon).

I reasoned that if this strategy for correcting gastro-intestinal problems could work on autistic children then it could work on everyone else. So far this assumption has proven true.

The pressure waves in the gut (peristalsis) are controlled by the pressure waves generated by the heart. Many stubborn gut disorders will not begin to heal unless the heart is treated first. The heart and gut are connected because they are both predominantly nerve tissue.

The digestive tract (gut) as a neurological organ

For thousands of years, Traditional Chinese Medicine (TCM) viewed the gut as the source of intellectual function…and they were laughed at by modern medicine for this seemingly absurd view.

However that all changed in the 1990’s with a book called “The Second Brain” written by Columbia University professor Dr. Michael Gershon.

The Second Brain details how the gut has its own independent nervous system (the enteric nervous system) that can act independently from the brain (similar to the heart). It has also been found that the gut actually contains more neurons than the brain and may even have a dominant controlling effect upon brain function (as opposed to the brain controlling the gut).

For me and my clinical practice, the key takeaway from the book is that 90% of our neurotransmitters are produced in the gut, not the brain. It’s like how your car uses gasoline, but the does not make gasoline.

Neurotransmitters are to the nervous system as hormones are to the endocrine system. Neurotransmitters such as serotonin, dopamine, GABA, and acetylcholine are needed for all phases of proper nervous system function and these components are produced in the gut.

It can thus be reasoned that gut problems such as constipation, colitis, and indigestion can have a causative effect on neurological issues related to the brain and even the heart, since the heart is predominantly a neurological organ.

All connected

The brain, heart, and gut are interrelated to each other through the dominant trait of being neurological organs. Issues with the brain, heart, and gut tend to be related to each other as nerve tissue disorders.

Issues with the heart can affect brain cognition and gut peristalsis. Improper gut peristalsis can result in impaired neurotransmitter production which then affects both the brain as well as the cardiac system. This can then result in symptoms such as insomnia, brain fog, heart palpitations, poor circulation, irritable bowel, and indigestion just to name a few.

The issues between these three organs are connected through the thread of nerve tissue.

The approach at our clinic is not to focus on the individual symptom or even organ. We focus on the pattern of nerve tissue dysfunction because doing so will have the broadest healing effect on the patient.

You’re going to hear me repeat this over and over again in my writings, and that’s ok because it’s important: The body is interconnected. And because it is interconnected it does not become sick in isolated parts but in systemic behavior patterns that encompass a wide range of organs that do not seem to relate to each other on the surface. But they are indeed related to each other through their dominant tissue type. It is not the symptom or organ that needs to be treated but the tissue pattern. Doing so will not only relieve the symptom but restore function and harmony to the whole body.

Epithelial tissue covers the surface of the body as skin and forms the lining of most internal cavities. The major functions of epithelial tissue include protection, absorption, secretion, and filtration.

When most people think of epithelial tissue they just think about the skin. However, the same epithelial tissue on the skin is located throughout the internal body and is reflective of several health issues.

Glandular epithelium

Your endocrine organs are primarily composed of a type of epithelial tissue known as “glandular epithelium”. The key feature of glandular epithelium is the ability to secrete substances such as hormones and waste products. This includes the major endocrine organs such as the thyroid, adrenals, testicles/ovaries, pancreas, etc. It also includes your sweat glands.

For this reason there is an intimate connection between the health of the skin and the health of the overall hormonal system. They are both composed of the same type of tissue.

Chronic skin conditions including eczema, psoriasis, and acne are often seen with hormonal issues related to the thyroid and sexual/reproductive organs. For these patients the skin problem is a reflection of deeper hormonal issues that must be addressed before the skin is improved.

The third kidneyThe skin and the kidneys are similar in that they both secrete fluid soluble waste from the body, in particular ureic acid (the same component in urine). For this reason the skin is seen as a backup kidney or “third kidney”.

Patients with kidney disease are prone to skin disorders for this reason. The body is unable to eliminate uric acid (among other components) through the normal route of the kidneys and thus it starts eliminating it through the skin. The elimination of uric acid through the skin not only produces a urine-like body odor (anyone who has been around patients with kidney failure will know what I’m talking about), but the acidic nature of uric acid creates a rash on the skin.

It doesn’t matter to me what name you give to the rash. You can call it eczema, psoriasis, dermatitis, acne…whatever. It doesn’t matter. What matters is that the body is eliminating fluid waste through the skin instead of the kidneys. If you can restore proper functioning to the kidneys so the body doesn’t feel the need to eliminate through the skin, the rash will naturally heal without the need for topical creams and lotions (which only mask the problem).

There can be several issues with the kidney including congestion of the tubules, blood sugar issues, blood pressure issues, and chronic infections of the urinary tract. Remember that endocrine organs are primarily epithelial, so issues related to the prostate and uterus can place pressure on the urinary tract and thus create a backflow of waste into the kidneys.

All of these issues need to be assessed on an individual basis for each patient. What’s important to realize is that the skin, kidneys, and endocrine organs are all connected through the thread of epithelial tissue. They have to be seen together as one unit and not in an isolated fashion.

Isolated treatment will produce isolated results and the body does not work in an isolated fashion.

Kidney and adrenals are one organ

Although they are classified as separate organs, the adrenal glands sit right on top of the kidneys and share a vascular connection. Issues that affect the kidneys have a direct effect on the adrenals and vice versa. So from a functional standpoint I see them as one organ.

Of all the endocrine organs, the adrenals are the most important from the standpoint of Traditional Chinese Medicine (TCM). In TCM there is a meridian called the “kidney meridian” that not only stores the deep energy reserves of the body, it is a reflection between the balance of Yin and Yang (PNS and SNS).

In my opinion, what the Chinese were describing as “kidney qi” was really the health of the adrenal glands. The adrenals are a primary regulator of hormones and blood sugar, thus they act as a reserve of energy and vitality. The adrenals also secrete stress hormones such as epinephrine and cortisol. These hormones can be both the cause as well as the effect of excess fight or flight (SNS) tone in the body. High epinephrine secretion by the adrenal glands can induce a state of panic throughout the body, and a state of panic can induce high epinephrine secretion and thus becomes a vicious cycle.

One of the most important functions of the adrenal glands is that they determine the level of SNS tone relative to PNS tone in the body. This has a direct effect on your ability to heal and recover from chronic illness.

Remember that you basically have two involuntary neurological states in the body: sympathetic and parasympathetic. The sympathetic response (SNS) triggers action and tension in response to a threat (both real and imaginary) while the parasympathetic response (PNS) triggers a rest and relax response needed for healing and repair.

The SNS and PNS act in a see-saw relationship. If one goes up, the other goes down. From the standpoint of health and wellness, most patients have too much SNS and not enough PNS. They can’t relax. They have chronic stress symptoms that have become embedded into their bodies and it’s affecting how they function.

The PNS is needed for proper digestion, elimination (bowel movements), sleep, relaxed muscle tone, and healthy sexual function, among other things. So when the patient is in a constant fight-or-flight state, a state of prolonged stress/anxiety/fear, it begins to compromise the body functions that depend upon a relaxed state. Specifically they begin to have stomach problems, problems going to the bathroom, insomnia, anxiety (including panic attacks), high blood pressure (which puts stress on the kidneys), vague aches and pains due to body tension, and loss of interest in sex.

These issues can be traced back to the adrenal glands, which are related to the kidneys, which are related to the skin, which are then related to the entire endocrine system. What connects these elements together is that they share the common thread of being epithelial tissue.

The skin and SNS

During embryonic development there are three germ layers that emerge from the fertilized egg and then form every part of your body. These three germ layers are the endoderm, ectoderm, and mesoderm.

The skin and the brain both originate from the same germ layer, the ectoderm. Thus there exists a deep connection between the skin and the brain at the germ level.

Approximately 80% of your sympathetic nerve fibers are located on the skin. It is estimated that if you removed everything from a persons’ body and just left the superficial sympathetic fibers intact, you’d still be able to recognize that person.

The other 20% of sympathetic fibers are located in the central nervous system and other centers in the body including the heart and adrenals.

Why are your sympathetic nerves so concentrated on your skin? If you imagine a human as a prehistoric being (millions of years ago) your body would want to know if there is a threat to your safety by the way something made contact with your skin.

Getting cut by a thorn, burned by a fire, bitten by a snake are all threats to your body that your brain would want to know about right away. It is for this reason that most of your fight-or-flight nerves are on your skin.

As an example, walk up next to a friend and gently place your palm on their arm. Probably won’t be a problem. Now, walk up to another friend and make your hand in the shape of a claw and place the tips of your five fingers on their arm. This will elicit more of a startle reaction because the claw resembles a bite. We are inherently programmed to be alarmed by the sensation of anything resembling a bite due to our prehistoric survival mechanisms.

One explanation of acupuncture

We’ve discussed the embryonic relationship of the sympathetic fibers on the skin relative to the central nervous system. This connection is through the skin and brain’s mutual origination in the ectoderm as well as the majority of sympathetic fibers being on the skin.

The sympathetic fibers thus form a direct link between the nerves in the skin relative to the brain, spinal cord, and other areas of the body sensitive to sympathetic nerves (such as the heart and adrenals).

One theory of how acupuncture works from a western science standpoint is through this relationship between the skin and brain. Somehow, over thousands of years of trial and error, the ancient Chinese were able to observe this relationship and map out the various pressure points and sympathetic nerve pathways of the body.

Based on this theory, acupuncture has a direct effect on the sympathetic nervous system through the connection between the skin and brain. Depending on what points are selected and how they are needled, a skilled acupuncturist can either increase or decrease the SNS based on the patient’s needs. In modern America most people suffer from having too much sympathetic tone and thus suffer from stress induced disorders. In this case acupuncture can be performed to decrease sympathetic tone which would thus increase parasympathetic tone. The increase in parasympathetic tone will have beneficial effects on digestion, bowel movements, sleep, and hormonal secretion, just to name a few.

Putting it all together

The skin, kidneys, adrenals, endocrine system, and SNS are all connected to each other through the common thread of being epithelial in nature. I realize sympathetic fibers are actually nerves and not epithelial tissue, but due to their density on the skin I see them as related to epithelial disorders.

Chronic skin disorders tend to come with hormonal disorders. Hormonal disorders tend to come with problems related to the kidney. Kidney issues also affect the adrenals. The adrenals can affect the blood pressure. All of this can be affected by too much fight-or-flight (sympathetic) activity in the nervous system, which in the case of the SNS is predominantly on the skin.

These combined elements form what I call the “epithelial pattern” of illness. Problems with epithelial related tissues come in clusters when you assess patients. Of course, each epithelial pattern will be unique to each patient. For one person it might just be panic attacks with indigestion, another might be eczema with thyroid disorders, but the underlying theme that connects their problems is that it stems from epithelial tissue. It is the broad pattern of epithelial tissue that needs to be addressed, not the isolated symptoms.

Remember, isolated treatment leads to isolated results because the body does not function in an isolated fashion. Additionally, isolated results tend to be temporary at best because you did not restore function to the body as a whole.

Key difference between nerve and epithelial pattern

The nerve tissue pattern centers on the brain, heart, and gut. The key symptom is autonomic dystonia. The body is not able to initiate responses of the SNS and PNS in a reliable manner. This creates a disorganized state of the nervous system where the body responds in an unpredictable way to stimuli. This type of pattern is frustrating to work with as a clinician because the patient tends to have an opposite response to treatment. A sedative makes them jittery, a stimulant makes them sleepy, etc.

The epithelial pattern centers on the skin, kidneys, adrenals, endocrine system, and sympathetic nerves in particular. The key symptom is an excessive degree of sympathetic tone in the body which then creates a lack of parasympathetic tone. This person is constantly tense. They can’t relax. Because of this they can’t digest their food, have trouble sleeping, and tend towards anxiety disorders. The high cortisol and epinephrine associated with this pattern tends to create hormonal issues which can involve not only the thyroid but the reproductive organs. Since the adrenals also regulate blood sugar, this person can tend towards metabolic syndrome and even diabetic states.

To use a car analogy, the nerve pattern patient has had the gas and brake pedal switched in place without knowing it. Because of this they are unable to control the car (their body) in a predictable manner. This patient feels as if they have lost the ability to control their body in some way.

In the epithelial patient, the gas and brake pedal are in the right places, but the gas pedal is nailed to the floor and the brake pedal is not working. This patient feels that they are in a constant state of being threatened by something. They may not even be aware of anything threatening them, but their body is behaving as if some sort of perceived threat is on the horizon. This person feels that they need to either fight something or flee from something. They can’t relax their body and/or mind.

While the nerve patient has the opposite response to stimuli, the epithelial patient tends to have no response to stimuli because they are trapped in a state of fight-or-flight.

Connective tissue is everywhere in your body. Connective tissue holds all of your cells, organs, and body parts in place and gives you form and shape. Without connective tissue you would be a blob of cells on the floor with no definite shape.

The most commonly known types of connective tissue are tendons (which attach muscles to bones), ligaments (attach bones to other bones), bones, and blood. Tendons, ligaments, and bones are what your joints are made out of, so most orthopedic issues such as back and neck pain can be classified as connective tissue disorders. Most people don’t realize that blood is also a connective tissue. But one way to make sense of this is to realize that red blood cells are produced in the bone marrow, thus it is born directly from connective tissue.

The extracellular matrix (ECM)

What makes connective tissue unique is that it is mostly composed of non-living tissue called the extracellular matrix (ECM). The ECM is composed of collagen fibers and a watery Jell-O-like substance known as “ground substance”. The ECM holds your cells within this mesh of fibers and ground substance. The ECM thus gives shape and form to your body. It is because of the ECM that your organs stay in one location and your bones retain their general shape.

The easiest way that I can describe the ECM to you is to imagine a Jell-O mold with pieces of candy floating inside the mold. The ECM is the Jell-O and the pieces of candy are your cells. Within the ECM the cells are not touching each other nor are they directly next to a capillary.

Before learning about the ECM I used to think that cells were right next to capillaries where they could exchange nutrients and waste directly with the bloodstream. This is incorrect. The capillaries run through the ECM and substances actually diffuse out of the capillary and through the ECM into the cells. The reverse also happens where waste products diffuse out of the cell and into the ECM which then guides the waste products to the capillary.

So I originally said that the ECM is not alive, but somehow it is responsible for nutrient and waste exchange between cells and the bloodstream. How does the ECM recognize nutrients vs. waste? How does it know where to guide substances within the infinite range of cells and capillaries? Even though the ECM is not “alive” by our definition of life, it clearly has a form of intelligence and performs a vital function.

And by the way, the mechanism behind the ECM’s ability to accurately direct nutrient and waste flow through the Jell-O-like ground substance is not known. There is definitely some form of intelligent action on the part of the ECM, but it is currently not understood (yet).

The ECM and inflammation

A lot of people talk about inflammation like it’s a bad thing, yet when asked about it do not know what inflammation actually is.

Inflammation is the process by which your body repairs damage. That’s all it is. When a part of you becomes damaged by either trauma, infection, poisoning, stress, etc. the body sets out to repair the damage. During this repair process you see four key traits: heat, swelling, redness, and pain. Once the damage is repaired the inflammation stops.

But what if the damage doesn’t get repaired or keeps occurring? If the damage doesn’t go away for some reason, or keeps happening, then the inflammatory response can become chronic. This is where you begin to see issues with chronic pain, swelling, and any disease that ends with “itis” (arthritis, sinusitis, colitis, dermatitis).

Inflammation is actually good and necessary for healing if it’s a short-term phenomenon. But if it’s happening non-stop and over extended periods of time then it means that something is going on inside of your body that keeps creating tissue damage, and thus the need for a repair process. The inflammation in of itself is not the bad guy, but it is a sign that there’s something wrong.

If the source of the inflammation is not addressed, chronic inflammation can progress to an auto-immune condition where the body starts attacking its own healthy tissue. What happens in auto-immune conditions is that the immune system spends so much time in a combative state that it becomes reckless and starts indiscriminately attacking tissue that is not posing a threat. It’s like an abused dog that lashes out against anyone that comes near it, even if that person wants to help it.

The ECM plays a key role in the initiation of the inflammatory response. If you get a cut on your arm, for example, it is the ECM that orchestrates the healing and inflammation response by directing substances to and from the site of injury. It does this using a similar mechanism by which it orchestrates nutrient and waste flow.

Because the ECM orchestrates the inflammatory response in times of injury, it can also be responsible for chronic states of inflammation as well as the auto-immune state, especially when the ECM becomes pathologic or dysfunctional. An additional problem with a dysfunctional ECM is that it can fail to initiate an inflammatory response when necessary, thus impairing the body’s ability to heal from damage.

The failure of the ECM to either resolve a chronic inflammatory state, or to initiate an inflammatory response where tissue repair is needed, is a distinguishing trait of auto-immune conditions as well as connective tissue disorders. It is the inability to both stop and start inflammatory processes within the connective tissue matrix that underlie conditions such as lupus, Hashimoto’s, arthritis, psoriasis, and so on.

The location and specifics of the disease are not as important as its underlying tissue dysfunction. If you look at most autoimmune conditions there is a lot of overlap in diagnostic criteria between them, which is why they can be so hard to diagnose. Instead of focusing on the specifics of the disease, which can result in an endless merry-go-round of chasing symptoms, I have found a more efficient approach in restoring functionality to the ECM and allowing the body to better regulate the inflammatory process.

Acupuncture meridians as a working model of the ECM

Alfred Pischinger, MD (1899-1982) was an Austrian physician who devoted his life to studying the ECM. He began publishing research on the ECM in 1926 and continued until the late seventies.

It was Dr. Pischinger who discovered the living behavior of the ECM and how it initiated both cell repair and destruction. Pischinger proved that the ECM contains an electrical potential that transmits information to and from the central nervous system and thus the entire body. His research shows the ECM as a mediator of information between the nervous and endocrine systems, and thus a key player in the start of disease. Ultimately, Pischinger felt that all chronic disease began in the ECM, and thus treatment should begin in the ECM as well.

Pischinger became interested in acupuncture as a consequence of his research starting in the 1920’s. Although he was able to prove the living behavior of the ECM, there was no scientific basis to explain its behavior. In his search to explain the behavior of the ECM he found the theories of acupuncture to give the closest explanation of how disease can both start and end in the connective tissue. Towards the end of his life he became increasingly fascinated with acupuncture and how it served as a practical application of his theories on the ECM. If there was any one person who gave validity to the study of acupuncture in Europe, it was Alfred Pischinger.

Pischinger felt that the Chinese had somehow observed the relationship between connective tissue (especially fascia) and internal organ function. After making this observation they spent thousands of years documenting the effect of stimulating certain areas of connective tissue and its relationship to organ function. These stimulation areas became known as acupuncture points and the effect of these points became the basis of Chinese medicine. It is through an understanding of the ECM that we can see how a pressure point on the foot can affect liver function, and a point on the hand can affect lung function. These points have the ability to affect the electrical potential of the body (through the ground substance) relative to the central nervous system and its relationship to specific organs.

The effects of acupuncture can thus be explained through its ability to regulate the electrical potential in the ECM, thereby affecting central nervous system function. Specific effects on the central nervous system are then relayed to both body tissues and internal organs. As it relates to connective tissue and autoimmune disease, the key characteristic is pain and inflammation (regardless of the diagnosis) since the inflammatory process is governed by the ECM. If you can restore functionality to the ECM, using the acupuncture meridians as a practical model, the body will then regulate inflammation and restore health.

For further reading on Pischinger’s work: “The Extracellular Matrix and Ground Regulation” by Alfred Pischinger is available on Amazon.

Connective tissue pattern summary

The connective tissue patient has difficulty regulating the inflammatory response. This pattern is seen in autoimmune conditions such as lupus or Hashimoto’s, but it is also seen in chronic orthopedic issues such as neck and back pain. It doesn’t matter what the diagnosis or label is. What matters is the behavior of the tissue and its inability to regulate inflammation.

Although it’s mostly composed of non-living cells, the connective tissue displays a complex system of intelligence that we still don’t completely understand. As an acupuncturist who has studied Alfred Pischinger’s work, my opinion is that the connective tissue represents a translational bridge between the neurological and hormonal systems of the body. This explains how manipulation of the fascia can effect nerves, hormones, and the inflammatory response.

Muscle tissue pattern

Key elements: muscle tissue, lactic acid

Key symptoms: chronic fatigue, diffuse muscle aches (fibromyalgia), frequent colds/flu, shortness of breathThe fourth and final type of body tissue is muscle. There are three types of muscle in your body.Skeletal muscles are muscles that attach to your skeleton and are thus responsible for moving your bones. These are the muscles everyone is familiar with such as the biceps, glutes, and calf muscles. Skeletal muscles are under voluntary control.

Smooth muscles are generally more involved in organ function and are not under voluntary control. Smooth muscles do things like move food through your bowels (digestion) and make your hair stand up when you’re frightened.

Cardiac muscle is found in your heart and controls the heartbeat, obviously this is involuntary.The key trait of muscle tissue is that they contract and elongate in order to create movement within the body.

Aerobic vs. anaerobic metabolism

Your muscles have two primary ways of generating energy to create movement. These two ways are known as aerobic and anaerobic metabolism.

The word “aerobic” means “with oxygen”. This is the primary source of energy production and involves the utilization of oxygen (along with fatty acids) to produce energy. Think of light aerobic exercise like a leisurely walk where you are relaxed and not working too hard. This form of energy production is steady, slow, and does not generate too much metabolic waste.

The word “anaerobic” means “without oxygen”. In terms of muscle tissue the secondary source of energy production is glucose (sugar). Think of anaerobic exercise such as heavy weight lifting or running into a sprint. From an evolutionary standpoint this form of metabolism was needed for fight-or-flight reactions such as running away from predators. In anaerobic metabolism, quick, fast-burning energy is needed. The aerobic pathway using oxygen to create energy is too slow for fight-or-flight reactions. In this case glucose is used to sustain an emergency reaction. Unlike oxygen, glucose is not a clean burning fuel and creates a lot of waste products in the body. The primary waste product it creates is called lactic acid.

Lactic acidosis

Think of lactic acid like the exhaust fumes coming out of your car. When the car is at rest there is little exhaust coming out, but if you suddenly slam on the gas pedal the amount of exhaust increases. That’s what the production of lactic acid is like in your muscles. It’s a waste product created as a result of glucose based metabolism (anaerobic metabolism). The more the body moves into a fast, emergency type state, the more lactic acid is released from the muscles.

Its lactic acid that makes your muscles feel sore and crampy during a heavy workout. As the lactic acid is released into the bloodstream it compromises your muscles ability to absorb oxygen. When the level of oxygen supply to the muscle reaches a low enough point, the muscle suffocates and that’s what gives you that cramping sensation.If this is done periodically it’s not a problem and is actually beneficial to the body. As long as there’s a good amount of aerobic metabolism between bouts of anaerobic metabolism, the body has plenty of time to clear out the lactic acid through the lymphatic system.

But what if this anaerobic (glucose burning) state goes on for too long? It doesn’t require that the person is constantly sprinting or lifting weights all day either! What if the person is just sitting around and for some reason is in an anaerobic (glucose) state when they really should be in an aerobic (oxygen) state?

Maybe this person has an anxiety disorder that causes their body to be in a constant state of fight-or-flight even when there’s no immediate threat. Maybe they have a problem utilizing oxygen in their cells which then forces the cell to use glucose as a secondary fuel source, otherwise the cell dies. Maybe the glucose level in the blood is too high either due to diet or insulin dysregulation and the cell is forced to metabolize the glucose and thus create lactic acid. Maybe they have a circulatory disorder (including poor blood count/quality) that is preventing the delivery of oxygen to the cells, etc. etc.

There can be many different reasons why this person has shifted into a constant anaerobic state. This has to be examined on each individual patient.

If the anaerobic (glucose) state goes on for too long, without enough periods of aerobic (oxygen) metabolism to clear out the lactic acid, you eventually end up with a high level of lactic acid in the blood known as “lactic acidosis”.

In this condition, the lactic acid reduces oxygenation to the muscle cells and you end up with the distinct crampy, achy pain that you see in fibromyalgia patients. Fibromyalgia pain is not the same as orthopedic pain where someone sprains their ankle while slipping on ice. Fibromyalgia pain is a deep, diffuse, spread-out ache in the muscle that results from the tissue being starved of oxygen.

Imagine the way your thighs felt after doing as many squats as you could. The ache that you felt in your legs was a result of the lactic acid production and its effect on oxygenation. For the fibromyalgia patient, that ache that you felt in your thighs is what they feel all over their body…all day long.

Lactic acid and chronic fatigue

To use the above analogy of how your muscles feel after a hard workout, imagine if your muscles felt that way all the time. Of course you’d be tired and everything would feel like a struggle, even simple tasks. This is why fibromyalgia type pain is usually accompanied by chronic fatigue to some degree.

One distinguishing trait of chronic fatigue due to lactic acidosis is that the patient constantly feels like they are suffocating and can’t get enough oxygen during inhalation. Even though they do not have restricted breathing (lungs are working fine), the saturation of lactic acid in the blood compromises the body’s ability to deliver oxygen to the cells. This type of patient thus feels like they are suffocating from the inside.

Because oxygen is so critical to cell function, the state of lactic acidosis is detrimental to all cell functions necessary for health and healing.

Lactic acid and chronic infections

In a state of chronic lactic acidosis the blood and lymphatics become congested with waste products. These waste products then combine with dead cells in your body (remember your cells are constantly dying and replenishing) and produce a toxic internal state that becomes a breeding ground for chronic infections (bacteria, viruses, molds, parasites). Lymphatic congestion, coupled with poor oxygenation, create an ideal environment for opportunistic infections to proliferate.

The human body is not sterile and was never meant to be. We are all populated with different bacteria, yeast, viruses, and even parasites that all play a role in healthy function. When the presence of these microorganisms stay below a certain threshold they exist is a symbiotic state that is mutually beneficial to both host and microbe. However when they multiply past this threshold the relationship now becomes parasitic and harmful to the host (human).

A person with a functioning immune system is able to regulate the degree to which these microbes exist inside of us. It allows them to exist just enough so that they are beneficial to us (such as helping to digest dead cellular material). But in a state of lactic acidosis the immune system becomes compromised as the internal environment becomes favorable to microbe growth.

In this situation the solution is not to keep trying to kill infections. That’s not addressing the source of the problem. Treating the source of the problem involves reducing the lactic acid burden, shifting the metabolic rate from anaerobic to aerobic (from yang to yin using Chinese terminology), and clearing out the resultant waste through the lymphatic system.

Muscle tissue pattern summary

The muscle tissue pattern is characterized by a chronic state of fatigue accompanied by widespread muscle aches. The degree of pain and fatigue can range from moderate to debilitating. Another key symptom is the feeling of suffocating from the inside out and not getting enough oxygen with each breath. Those who suffer with this pattern know exactly what I’m talking about when I say “suffocating from the inside out”, while those who don’t have this pattern find the phrase to be odd.

Muscle tissue patterns tend to create high levels of waste and internal toxicity in the body. This internal toxicity makes the person more susceptible to chronic infections and frequent bouts of the cold/flu. When I say “internal toxicity” I’m not necessarily referring to things like heavy metals or chemical toxicity which comes from the outside environment, I’m talking about your own metabolic waste products that each cell excretes. Just like you go to the bathroom every day to urinate and defecate, your individual cells excrete waste every day as well. If this waste is not properly removed (often due to lactic acidosis and the resultant lymphatic congestion) it becomes a breeding ground for bacteria, viruses, molds, parasites, etc. Don’t worry about environmental toxins if you’re not even able to excrete your own cellular waste.

For the muscle tissue pattern, the metabolic rate needs to be shifted from anaerobic back to aerobic. From yang back to yin. This will begin to reduce the production of lactic acid. As this happens the resultant waste needs to be cleansed from the lymphatic system. Once this happens energy and oxygenation can be restored to the tissue.This type of pattern will be seen in many diagnoses. What matters is not the diagnosis or the label of the condition. What matters is the specific behavior of the body which then indicates the dysfunctional tissue type. And remember there are only 4 tissues in the body so this conceptual model helps to reduce operator error on the part of the clinician. As treatment models become more complex, the greater the room for error and mistakes.

The 4 tissue patterns summary

The 4 tissue patterns is my attempt to organize complex and often conflicting patient symptoms into a concept model that can be used to resolve chronic illness. This paper represents a small summary (less than 10%) of the overall theory. I hope to write more about it as time allows. Because this theory is based on my clinical practice of treating real patients with real problems, anything I say represents my current understanding and is open to change as my observations change. I’m not an academic who sits around reading books all day while trying to fulfill grant requirements. I do this stuff for a living and my livelihood depends on getting sick people better.

The body is organized from general to specific. You start with nutrients, molecules, and water which combine to form cells. Cells combine to form 4 types of tissue. The 4 types of tissue combine to form organs. Organs combine to form systems. Systems are things like the cardiovascular system, digestive system, reproductive system, central nervous system, etc.

The patient suffers at the level of systems and wants help for a specific problem. But although the problem is seen at the systems level, it almost always originates at a more foundational level such as molecules, cells, and tissue. The body deteriorates at a general level, but the person suffers specific problems.

If you treat at the systems level you run the risk of doing symptomatic, Band-Aid type care that does not address the cause of the illness. The patient might feel better for a little while but often the problem returns with a vengeance. You also run the risk of creating imbalances in the body by trying to micromanage it. It is at the level of systems where diagnoses as well as treatments become numerous and complicated. If you’re going to be specific, then you better be exactly right! And if you are exactly right, you better be able to predict how long that answer will be correct because the body is constantly changing! It is at this level where the potential for operator error becomes very high. Because doctors are only human, high amounts of mistakes are inevitable.

If you treat at a level that is too general it may not be specific enough to address the patient’s suffering. It could also take way too long to get the person better. In some cases of severe deterioration the person might be dead before the treatment has enough time to take effect!

The four tissue patterns provide a compromise between specificity (micro) and generalization (macro). It’s a perfect middle ground that allows you to address fundamental root causes of illness while at the same time being specific enough to relieve suffering in a fast manner. Because there are only four types of tissue, the room for mistakes and operator error is much less than treating at more specialized levels.

There are only 4 types of tissue that everything in your body is made out of. Each tissue has a specific behavior dysfunction with primary body components.

Nerve tissue is reflected in the behavior of the heart, gut, and brain. Its primary dysfunction is autonomic dystonia where the body reacts in an unpredictable and often conflicting manner to stimuli. The gas and brake pedals of the car are switched in place.

Epithelial tissue is reflected in the behavior of the skin and hormonal systems. Its primary dysfunction is a state of hyper sympathetic tone with an accompanied lack of parasympathetic tone (too much yang, not enough yin). The gas pedal is nailed to the floor and the person can’t stop or slow down.

Connective tissue is reflected in the health of the joints and presence of inflammation. Its primary dysfunction is an inability to regulate inflammation and often results in orthopedic pain and autoimmune conditions.

Muscle tissue is reflected in the muscles and energy level of the body. Its primary dysfunction is lactic acidosis which leads to varying degrees of chronic pain, chronic infections, and fibromyalgia.

Every chronic illness you see will have elements of the above four patterns with one of them being the dominant pattern in the patient. If you can identify the dominant pattern and resolve it, the entire body will begin to heal because the four tissues are interdependent with each other.

It doesn’t matter what the disease label is. What matters is the behavior of the body because health is a verb, not a noun. Heath and disease are both behavior traits of the body that can be observed in broad systemic patterns. By looking at the behavior of the body you can identify the tissue type that reflects the pattern and proceed with effective care.

Further reading

Science of the Heart by Heartmath Institute: Goes into detail regarding the neurological and hormonal functions of the heart. This book is a good intro to neurocardiology and available for free at the Heartmath website (www.heartmath.org)

The Second Brain by Michael Gershon: Describes the neurological components of the gut and how gut behavior influences the central nervous system.

Neural Therapy by Robert Kidd: Goes into detail regarding the role of epithelial tissue and its effect on the neurological and hormonal systems.

The Extracellular Matrix and Ground Regulation by Alfred Pischinger: One of the most important medical books ever written in my opinion. Describes the yet unexplained intelligent nature of connective tissue and ground substance. This book was responsible for giving scientific validation to acupuncture and Chinese medicine.

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